ABSTRACT
The incidence of congenital cytomegalovirus (CMV) disease is dependent on the rate
of virus acquisition by susceptible women in temporal proximity to pregnancy. Information
about serostatus may help to identify high-risk groups and target interventions. Each
year from 1991 to 2000, cord blood specimens (surrogates for maternal serum) from
100 consecutive deliveries were obtained at three hospitals. The presence of CMV immunoglobulin
G antibody was correlated with demographic data. Overall, 58% of 2992 women were seropositive.
After stratification by socioeconomic status (SES), nonwhite race was strongly associated
with seropositivity (odds ratio, 3.0; 95% confidence interval [CI], 2.5 to 3.8), and
after stratification by race, lower SES also was associated (odds ratio, 2.0; 95%
CI, 1.7 to 2.3). There were no trends in seroprevalence over time in any demographic
group. However, among white women 21 to 29 years of age, a significant association
was found with later birth cohort. Seropositivity ranged from 40% among older, white
primigravidas of upper SES to 89% among older, nonwhite, multigravid women of lower
SES. These data suggest high rates of CMV transmission among nonwhite women of lower
SES. Because these women tended to deliver infants at younger ages, delaying pregnancy
even a few years might reduce the incidence of congenital disease. In contrast, most
white, upper SES women remain susceptible to primary infection during their childbearing
years. Such women born after 1975 may be more likely to reach the childbearing years
with CMV immunity as compared with women born before then.
KEYWORDS
Cytomegalovirus - pregnancy - seroepidemiology - congenital infection
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Gary S MarshallM.D.
Professor of Pediatrics, University of Louisville School of Medicine
571 S. Floyd Street, Suite 321
Louisville, KY 40202